279264 add new fields for php form

I have existing form that need to be modified by adding new fields: ADD the following fields in FORM SUBMIT PAGE: MIDDLE NAME: CELL PHONE: TIME AT RES ( WITH PULL DOWN FOR 1 TO 12 MONTHS, AND 1 TO 20 YEARS) PREVIOUS ADDRESS (IF "TIME AT RES" IS LESS THAN 2 YEAR REQUIRED) RENT/MORTGAGE AMOUNT EMPLOYER JOB TIME(WITH PULL DOWN) PREVIOUS EMPLOYER (IF LESS THAN 2 YEARS ON "JOB TIME") OCCUPATION GROSS MONTHLY INCOME OTHER SOURCE OF INCOME AND AMOUNT....... radio button: INDIVIDUAL & JOINT (IF DEALER CLICKS ON INDIVIDUAL THEN ONLY ONE APPLICATION IF DEALER CLICKS JOINT THEN JOINT APPLICATION POPS UP AT THE BOTTOM). BELOW APPLICATION IT NEEDS TO HAVE FOLLOWING FIELDS.... YR WITH PULL DOWN, MAKE, MODEL, VIN (NOT REQUIRED) BUT NEED OPTION TO TYPE, SALES PRICE, TRADE ALLOWANCE, PAYOFF ON TRADE The new fields should also be reflected in FORM VIEW page. i have PDF files which contains overall fields